Understanding Endometriosis and How it Affects Fertility
What is endometriosis?
Before we delve into the nitty gritty of the relationship between fertility and endometriosis, let’s first explore what endometriosis actually is.
Although a lot of hormonal intricacies are at play, in a nutshell, endometriosis occurs when tissue similar to the lining of the uterus (endometrial tissue) grows outside of the uterus in the abdomen and pelvic area. During a regular menstrual cycle, the uterine lining sheds, but with endometriosis, this tissue also thickens, breaks down, and bleeds – but outside of the uterus. Since this tissue has no exit route, it becomes trapped, causing pain and eventual scarring of the surrounding tissue.
Although endometriosis can impact any girl or woman who experiences menstrual periods, it’s much more common in women in their 30s and 40s.
Affecting up to 10% of women between the ages of 15 and 44, endometriosis occurs most often on or around reproductive organs in the pelvis or abdomen, including the:
- Fallopian tubes
- Ligaments around the uterus (uterosacral ligaments)
- Lining of the pelvic cavity
- Ovaries
- Outside surface of the uterus
- Space between the uterus and the rectum or bladder
Although much less common, it can also grow on and around the:
- Bladder
- Cervix
- Intestines
- Rectum
- Stomach (abdomen)
- Vagina or vulva
This growth can result in scarring around the affected areas, causing the pelvic tissues and organs to ‘stick together’. The endometrial tissue can grow, break down, and bleed during menstrual periods. Since the tissue doesn’t have a way to exit the body, it results in the symptoms commonly experienced by women with endometriosis, such as painful, heavy periods, and fertility problems.
What are the symptoms of endometriosis?
The most common signs of endometriosis are pain and difficulty getting pregnant.
Common symptoms of endometriosis include:
- Painful menstrual cramps that may go into the abdomen (stomach) or lower back
- Pain during or after sex
Other symptoms include:
- Diarrhea or constipation during a menstrual period
- Fatigue or low energy levels
- Heavy or irregular menstrual periods
- Pain with urination or bowel movements during menstrual periods
- Spotting or bleeding between menstrual periods
Every woman’s journey with endometriosis is unique. Symptoms can vary greatly, and some may experience only a few – or none at all. It’s important to note that having severe pain or other symptoms doesn’t always mean the condition is more severe.
While endometriosis is common, not everyone with the condition experiences noticeable symptoms. Sometimes, it’s only discovered incidentally during other medical procedures or fertility assessments.
Did you know…
FACT: It can take up to 10 years for a woman to be correctly diagnosed with endometriosis.
Is endometriosis preventable?
Unfortunately, it isn’t. Because endometriosis is an idiopathic condition, which means its exact cause is unknown. Additionally, there are no proven methods to prevent it from developing.
That being said, being informed about the symptoms and understanding your potential risk factors can empower you to have meaningful discussions with your doctor to develop an individualized care plan tailored to you.
Endometriosis and Infertility
Does endometriosis affect fertility?
In short, yes.
Naturally, women who are diagnosed with endometriosis have a lot of questions. A pertinent one being: will I be able to get pregnant?
Often, and thankfully, the answer is also yes.
Getting pregnant with endometriosis is possible, and although it may prove more challenging, you won’t necessarily have a more difficult pregnancy.
Let’s go back to basics: To conceive, an egg must be released from one of your ovaries. This egg then travels through one of the fallopian tubes, where it’s typically fertilized by sperm. The fertilized egg then attaches to the uterine lining.
When a woman has endometriosis, this seemingly straightforward process can face hurdles. The abnormal tissue outside the uterus can disrupt fertility by:
- Block the ovary from releasing eggs
- Block the fallopian tubes
- Stop the fallopian tubes from working properly
- Stop a fertilized egg from attaching to the uterus
Endometriosis can also have an impact on your fertility in other ways. It can damage the egg or sperm and can cause inflammation, which interferes with the balance of hormones that women need to become pregnant.
Although it can be more difficult to conceive, women with endometriosis are often still able to and can have children – especially with the right care.
Did you know…
FACT: 50% of women with endometriosis have difficulties in naturally conceiving.
Can endometriosis be treated? If so, how?
As of yet, there is no lasting treatment for endometriosis, per se, but experienced doctors can provide effective treatments that allow you to manage it. Choosing the right treatment course depends on various different factors, including your age, symptoms, and what stage of endometriosis you have.
So, endometriosis has stages?
Indeed, it does. Doctors classify endometriosis from stage 1 to stage 4. This helps determine the extent and severity of the condition based on where the endometrial tissue is located and how much is present in those areas.
It’s worth noting that the severity of endometriosis symptoms isn’t always linked to its stage. For example, some women with stage 4 endometriosis have few or no symptoms, while others with stage 1 can have severe symptoms.
Did you know…
FACT: 50% of women with unexplained infertility are found to have endometriosis.
What treatment should you get?
When it comes to treating endometriosis, it’s important to understand the difference between managing the symptoms and treating the condition itself. Medications, such as hormonal therapies, are mainly used to help with symptoms such as pain – and do not actually cure the underlying condition. They just help ease the discomfort that comes with it.
The most effective treatment for endometriosis involves a type of surgery called keyhole surgery, where an experienced physician carefully removes the endometrial tissue wherever it is found. This not only deals with the root of the issue but can also improve the chances of getting pregnant for those affected by endometriosis.
When it comes to deciding between taking medication for symptom relief or having surgery to remove the tissue, it really depends on various factors such as how severe the symptoms are, what stage of the condition you have, and if you want to have children. While medication can give temporary relief, surgery is the only way to potentially get rid of endometriosis and improve the chances of natural conception.
To conclude…
Understanding endometriosis and its impact on fertility is crucial for women navigating the condition. While it does present challenges, especially when it comes to conceiving, various options are available for managing symptoms and achieving pregnancy. By working closely with experts to explore personalized treatment plans, women with endometriosis can take proactive steps toward their reproductive health and overall well-being.
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